By Year End, Most Hospitals will be Smoke-free Facilities

Is it realistic to think that hospitalized smokers will adhere to this policy?

The Joint Commission's Health Services Research Department conducted a survey of nearly 2,000 hospitals and found that 45% have a smoke-free facility policy. This represents close to a 3% increase since 1992 when the Joint Commission required all of its accredited hospitals to ban smoking inside the hospital. Approximately 39% of hospitals now report that they do not have any designated smoking areas inside or outside of the hospital, so these hospitals are considered smoke-free campuses.

As an oncology nurse, I understand and support the intent of the Joint Commission's requirement. Smoking is a bad, nasty habit that affects not only the smoker, but everyone around him or her. But smoking is also a recognized addiction and most smokers are physically dependent on nicotine. To think that they will magically adhere to smoke-free hospital policies when they are hospitalized (or visit, or work in a hospital) is ludicrous. Instead, unintended consequences may occur; consequences that may be as or more harmful than smoking itself. One of the most common causes of hospital fires is smoking, especially "sneaky smoking" in storage rooms, bathrooms, and other out-of-the way places that smokers seem to find in hospitals. Similarly, when designated smoking areas are located far from the hospital and when smoking is prohibited on hospital property, smokers are not likely to refrain from smoking. Instead, in many cases, they will drag their IV poles and other medical equipment to the far reaches of the parking lot or property to light up. Along the way, they are at risk for falls and are at risk for harm from (in most cases) being unsupervised by hospital personnel while they are out having a smoke. I have heard of several patients who have fallen, collapsed, or injured themselves on the way to, or coming from, the designated smoking area. Hospitals' designated smoking areas are almost always outside, adding the element of inclement weather to the mix. At some hospitals where smoking is banned on hospital property and not just inside the hospital, you'll see patients and employees gathering at the curb by the street or along the edges of the property in order to smoke. Again, it presents a safety hazard when smokers are standing on the shoulder of the road so they won't violate policy by smoking on hospital property.

I am not a smoker, nor am I a proponent of smoking. But I am concerned about patient (and visitor, and employee) safety. While it sounds good to have smoke-free hospitals and smoke-free hospital campuses, it may not be so good after all.